Retrospective study of ifosfamide-induced encephalopathy in children and young adults

Ifosfamide, an alkylating agent used for treating various cancers, like bone and soft tissue sarcomas, can cause encephalopathy in 10%-30% of adults and 8% of children, presenting with symptoms such as confusion, drowsiness, seizures, and, in severe cases, coma. A retrospective study of 24 patients aged 4-30 years at MD Anderson Cancer Center (Houston, TX) found that encephalopathy occurred with both short and continuous ifosfamide infusions, typically emerging within hours to a few days of treatment, and resolving within 1 to 5 days. Most of the patients received methylene blue for symptom management, with improvement seen for the majority, thouth recurrence occurred in some re-exposed patients even with preventive treatment. The authors conclude that these findings highlight the variable presentations of ifosfamide-induced encephalopathy.